1. Moylan, Lois Biggin PhD, RN


Our varied professional roles should serve to unite, not divide, us.


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"Didn't you used to be a nurse?" I'm often asked when someone learns I have a doctoral degree in nursing, teach, and conduct research. I'm still a nurse, I explain, and my current role is, indeed, a nursing role.


"That isn't real nursing," they usually say. "You're not caring for patients." As a patient advocate who's devoted my life to nursing, I'm disturbed by this perception that my contributions in various professional roles don't constitute "real" nursing.


Perhaps even more troubling is the view among many nurses that these differing professional roles divide us. Some bedside nurses, for example, perceive their role to be less valued by health care professionals than that of nurses with advanced education-and, unfortunately, there may be some advanced practice nurses who perceive their position to be a superior one.


For many years, I've occasionally worked as a staff nurse during weekends or summers, to hone my clinical skills and because I thoroughly enjoy this contact with patients. Yet I sometimes experienced a disconcerting response from the staff nurses on the acute care units where I worked. Although many were welcoming, others asked why, with my credentials, I chose to return to the bedside. I was treated like an intruder and reminded that advanced degrees weren't necessary there. I was saddened by the staff nurses' response, which seemed to reflect their defensiveness and belief that we, as nurses, were so different.


It's a privilege to be able to practice what I teach. If I thought hands-on caring was beneath me, it would be unethical of me to be a clinical nursing instructor. Many of my colleagues have also talked about deriving great satisfaction from clinical per diem practice and valuing the opportunity to engage in clinical practice at the bedside during the summer months. For the last several years, I've been unable to work in an acute care setting because of physical limitations, and it's something I miss dearly. After all, the goal of all nursing roles is to provide excellent patient care, and one of the most immediate ways to feel you've achieved this is by providing it directly.


Yet being a nurse doesn't mean you have to be at the bedside. Professional nurses can have many roles, and these should be viewed as complementary. While many RNs continue to think nurse teachers, researchers, and legal consultants, for example, are isolated from bedside practice, their counterparts in medicine and the law aren't so divisively categorized. Both of these professions seem to allow for more leeway when it comes to defining a physician or a lawyer. This attitude among nurses prevents us from uniting in our efforts to improve standards of practice and the status of nursing, which undermines our profession, dilutes our power base, and impacts our credibility.

Figure. Lois Biggin ... - Click to enlarge in new windowFigure. Lois Biggin Moylan

Providing quality nursing services to the public requires a coordinated effort by nurses in various areas of expertise. The nurse administrator develops effective policies and acts as a patient advocate. The nurse researcher produces and tests evidence to determine effective interventions that will lead to advances in both theory and practice. The nurse educator prepares students for the challenge of providing excellent patient care. The staff nurse provides direct patient care. The NP reaches the most vulnerable populations, which otherwise wouldn't have access to appropriate health care services. The clinical nurse specialist's expert skills support other nurses in their many roles. The informatics nurse develops technology that prevents errors and improves health care delivery services. The nurse ethicist contributes to the development of professional standards. Nurses who make public policy safeguard the health of our society.


We're all real nurses, providing care in a multitude of ways and settings. And it takes all of us together, working in our many diverse roles, to achieve our goal of providing the highest level of patient care and gaining the recognition nurses deserve.